Dr. James S. Castle | NorthShore
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James S. Castle, M.D.

James S. Castle, M.D.

James S. Castle, M.D.

Neurology
  • Locations
    Locations
    A

    NorthShore Medical Group

    757 Park Ave. West
    Suite 2850
    Highland Park, IL 60035
    847.570.2570 847.570.2073 fax Get Directions This location is wheelchair accessible.
    B

    NorthShore Medical Group

    920 Milwaukee Ave.
    Suite 2100
    Lincolnshire, IL 60069
    847.570.2570 847.570.2073 fax Get Directions This location is wheelchair accessible.
    C

    NorthShore Medical Group

    9650 Gross Point Rd.
    Suite 3900
    Skokie, IL 60076
    847.570.2570 847.570.2073 fax Get Directions This location is wheelchair accessible.
    D

    NorthShore Medical Group

    2180 Pfingsten Rd.
    Suite 2000
    Glenview, IL 60026
    847.570.2570 847.570.2073 fax Get Directions This location is wheelchair accessible.
  • Publications
    Publications
    • Agreement regarding diagnosis of transient ischemic attack fairly low among stroke-trained neurologists.

      Stroke 2010 Jul

      Authors: Castle J, Mlynash M, Lee K, Caulfield AF, Wolford C, Kemp S, Hamilton S, Albers GW, Olivot JM
      Abstract
      Agreement between physicians to define the likelihood of a transient ischemic attack (TIA) remains poor. Several studies have compared neurologists with nonneurologists, and neurologists among themselves, but not between fellowship-trained stroke neurologists. We investigated the diagnostic agreement in 55 patients with suspected TIA.
      The history and physical examination findings of 55 patients referred to the Stanford TIA clinic from the Stanford emergency room were blindly reviewed by 3 fellowship-trained stroke neurologists who had no knowledge of any test results or patient outcomes. Each patient's presentation was rated as to the likelihood that the presentation was consistent with TIA. We used 3 different scales (2-, 3-, and 4-point scales) to define TIA likelihood. We assessed global agreement between the raters and evaluated the biases related to individual raters and scale type.
      The agreement between fellowship-trained stroke neurologists remained poor regardless of the rating system used and the statistical test used to measure it. Difference in rating bias among all raters was significant for each scale: P=0.001, 0.012, and <0.001. In addition, for each reviewer, the rate of labeling an event an "unlikely TIA" progressively decreased with the number of points that composed the scale.
      TIA remains a highly subjective diagnosis, even among stroke subspecialists. The use of confirmatory testing beyond clinical judgment is needed to help solidify the diagnosis. Caution should be used when diagnosing an event as a possible TIA.
      PMID: 20508192 [PubMed - as supplied by publisher]
  • In the News
    In the News

    Oct 2013

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